Dentaltown November 2015 - (Page 46)
pediatric dentistry
feature
by Josh Wren, DMD
Space Maintenance:
The Right Appliance at the Right Time
O
One of the most common questions asked on the Dentaltown pediatric dentistry message boards is, "Do I
need to place a space maintainer here? If I do need a space maintainer, which one do I need?" My goal of
this article is to address those two questions.
Ask any orthodontist the following question: "Is it easier to put the teeth where they need to be if you
have the space available, or is it easier to create the space first then put the teeth where they need to go?"
The following examples are general examples only. There are often other variables that can influence the
use of a particular space maintainer.
Missing "d"
Missing "e"
Six-year molar fully erupted and in occlusion:
No space maintainer needed
Six-year molar not erupted: Distal shoe or no space
maintainer (distal shoes are an advanced space maintainer
procedure and not necessarily the standard of care-no
space maintenance is a possible option).
Fig. 1 "d" needs to be
extracted but six-year
molar is fully erupted
Distal shoes must be followed radiographically at each
recall appointment. The blade portion that contacts the
mesial of the six-year molar usually needs to be shortened
once or twice before the six-year molar is fully erupted.
A "d" is a primary first molar-tooth #'s B, I, L or S
Six-year molar not erupted, or not fully erupted:
Band and loop is indicated
An "e" is a primary second molar-tooth #'s A, J, K, or T
Fig. 3a Distal shoe-a
pre-cementation
radiograph is a must
Fig. 2a Band and loop is
indicated until the six-year
molar is fully erupted
Fig. 3b Blade location is
close but not ideal
Fig. 2b Band and loop has
maintained the "d space"
and can now be removed
Fig. 3c Blade location is
ready for cementation
46
NOVEMBER 2015 // dentaltown.com
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Table of Contents for the Digital Edition of Dentaltown November 2015
On Dentaltown.com
HOWARD SPEAKS: Avoid a Perfect Storm: Focus on Infection Control
PROFESSIONAL COURTESY: Suffering from Arithmophobia?
Continuing Education Update
Industry News
Check Out This Broken Implant
Disaster Case— Hail Mary
Internal Marketing Begets Referrals
When to Refer to a Periodontist
Parents in the Operatory: Friend or Foe?
What You Need to Know to Hire the Perfect Hygienist
Space Maintenance: The Right Appliance at the Right Time
Practice Solutions: AMD LASERS
Practice Solutions: Planmeca
Product Profi le: DentalMarketing.net
Adhesives: 60 Years of Clinical and Chemical Improvement
Poll
Product Profi le: DEXIS
Misaligned Anterior Teeth Straightened with Direct Composite Bonding
Five Common Web Design Mistakes
You’re a Public-Health Dentist and You Didn’t Even Know It!
Retirement Planning Made Simple
Young Patient Redefi nes the Face of Dentures
New Products
Healthy Mouth, Healthy Body: A Patient Info Sheet
Ad Index
You Should Know: Synergy Dental Partners
Practice Growth Fueled by Technology
The Clinical Algorithms of Rehabilitation
Dentally Incorrect
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